WHAT IS IT?

It is an inflammatory bowel disease that causes inflammation and ulceration of the inner lining of the rectum and colon. Tiny ulcers develop on the surface of the lining which may bleed and produce pus.

It affects approximately 146,000 people in the UK, and is more common in northern developed areas.

 

PATHOPHYSIOLOGY

In patients with inflammatory bowel disease, these phagocytes may begin to respond to gut flora, secreting pro-inflammatory cytokines that activate a certain population of T cells. This results in mucosal inflammation and damage. In particular, there is speculation that interleukin (IL)–25, which controls certain aspects of T helper cell response, may be abnormal or deficient in some patients with inflammatory bowel disease. Microbiotic flora in patients with the disease is less diverse in patients without, and they have more gut pathogens which is the bad bacteria.

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CAUSES

Its thought to be an autoimmune condition, possibly caused by a combination of your genes, an abnormal reaction of the digestive system to bacteria in the gut, along which an unknown trigger which could be a virus, diet, stress.

It affects non-smokers more frequently

 

SYMPTOMS

The main symptom is recurring diarrhoea that may contain blood, mucus or pus, abdominal pain, weight loss, fatigue and needing to empty their bowels frequently.

The symptoms vary from very mild to severe, and patients may experience periods or remission or relapses. During a flare-up a patient may experience symptoms elsewhere in the body such as arthritis, mouth ulcers, painful swollen skins, and irritated eyes. Severe cases are defined as having to empty your bowels 6 or more time a day, and other symptoms may include shortness of breath, fast/irregular heartbeat, and a fever.

 

 

DIAGNOSIS

Physical examination, checking for paleness (anaemia) and stomach tenderness. A stool sample is taken to check for and rule out infection. A colonoscopy may be used to examine/ take a biopsy.

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DRUG TREATMENT

• 5-amino salicylic acids (sulphasalzine/mesalazine)

• Corticosteriods (prednisolone)

• Immunosupressants: azathioprine

• Ciclosporin

• Biologic medications (infliximab/adalimumab)

• Methotrexate

 

Surgery may be required in more severe cases. Such as removing the colon (colectomy). Or having an ileostomy or ileo-anal pouch (when part of the small intestine is used to create an internal pouch that is then connected to the anus).